Related Experiment Video
Updated: Mar 1, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
AssesSment of the left atrial appendage morphoLogy in patients aAfter ischaeMic Stroke - the ASSAM study protocol
Jakub Baran1, Ilona Michałowska, Ilona Kowalik
1Division of Clinical Electrophysiology, Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland, Poland. j.baran@sampi.pl.
Insights
Left atrial appendage morphology may be an unknown risk factor for stroke in atrial fibrillation (AF) patients. The ASSAM study investigates this link, comparing stroke patients with controls undergoing AF ablation.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Atrial fibrillation (AF) is a major risk factor for ischemic stroke.
- Current risk scores (e.g., CHA₂DS₂-VASc) identify known risk factors, but strokes still occur in anticoagulated patients.
- This suggests the existence of "unknown" risk factors influencing stroke risk in AF.
Purpose of the Study:
- To investigate left atrial appendage (LAA) morphology as a potential "unknown" risk factor for stroke in patients with atrial fibrillation.
- To compare LAA morphology between patients who experienced ischemic stroke/TIA despite anticoagulation and AF patients without a history of stroke.
Main Methods:
- The ASSAM study is a planned investigation.
- It will enroll 100 patients who have experienced ischemic stroke or transient ischemic attack (TIA) while on anticoagulation.
- A control group of 100 patients scheduled for AF ablation without prior stroke/TIA will also be included.
Main Results:
- Results are pending as the ASSAM study is planned.
- Analysis will focus on differences in LAA morphology between the two groups.
- Correlation between specific LAA morphological features and stroke occurrence will be assessed.
Conclusions:
- Left atrial appendage morphology may represent a significant, yet uncharacterized, risk factor for stroke in atrial fibrillation.
- Identifying novel risk factors like LAA morphology could improve stroke risk stratification and prevention strategies in AF patients.
- Further research is warranted to validate these findings and integrate LAA morphology into clinical decision-making.
Abstract:
Stroke remains the most dangerous and frightening complication of atrial fibrillation (AF). A causal relationship between ischaemic stroke and atrial arrhythmias such as AF or atrial flutter has been well established. Numerous factors predisposing to peripheral embolism in patients with AF have been well established and included in the CHA₂DS₂-VASc score. Although proper anticoagulation minimises the risk attributable to "known" risk factors, stroke may still occur. Thus, "unknown" risk factors may play an important role in stroke risk stratification in patients with AF. We assume that one of the important "unknown" risk factor is the left atrial appendage morphology. The ASSAM study is planned to include 100 patients after ischaemic stroke or transient ischaemic attack (TIA) and known status of anticoagulation at the time of stroke. The control group will consist of 100 patients scheduled for AF ablation without a history of stroke or TIA.
Related Concept Videos
01:24Cardiac Catheterization III: Left Heart Catheterization
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests